PLEASE ENTER THIS/THESE DOGS ON THE FOLLOWING DATES: (place an X in the
appropriate box(es) and type in the race date(s))

[ ] FRIDAY (if offered), (type in date here) ,
2013

[ ] SATURDAY, (type in date here) , 2013

[ ] SUNDAY, (type in date here) ,2013

[ ] MONDAY (if offered), (type in date here) ,2013

I CERTIFY that I am the actual owner of this dog, or that I am
the duly authorized agent of the actual owner whose name I have entered above.
In consideration of the acceptance of this entry and the opportunity to have
this dog race, I (we) agree to abide by the rules and regulations of the
CANADIAN AMATEUR RACING ASSOCIATION in effect at the time of this race meet, and
by any additional rules and regulations appearing in the premium list for this
race meet. I (we) agree that the Basenji Club Of Canada, Greyhound Club of
Canada, Ontario Racing Association, Whippet Club of British Columbia, Canadian
Amateur Racing Association member Club, holding this Race meet has the right to
refuse this entry for cause, which any of those named clubs shall deem to be
sufficient. I (we) agree to hold the Club(s), its members, directors, governors,
officers, agents or other functionaries, any employees of the aforementioned
parties and the Owners of the Property of the practice premises or grounds
harmless from any claim for loss or injury which may be alleged to have been
caused directly or indirectly to any person or thing by the act of this dog
while in or upon the practice/certification meet premises or grounds or near any
entrance thereto and I (we) personally assume all responsibility and liability
for any such claim, and I (we) further agree to hold the aforementioned parties
harmless from any claim loss of this dog by disappearance, theft damage or
injury be caused or alleged to be caused by the negligence of the Club(s) or any
of the aforementioned parties or by the negligence of any person or any other
cause or causes. I (we) certify and represent that the dog entered is not a
hazard to person or other dogs. This entry is submitted for acceptance of the
forgoing representations and agreements.